A Case of Toe Necrosis after Treatment with Phenol Cauterization for Ingrown Toenail

Abstract

A difficult-to-treat case was experienced in which a patient’s left first toe necrotized after the phenol procedure for ingrown nails. The patient was a 59-year-old male. As for his past medical history, dialysis was instituted due to glomerulonephritis in1996 and a left femoral-right femoral artery bypass was created for peripheral arterial disease (PAD) in 2015. There was nothing special about his family history, and he did not drink or smoke. In March 2020, the patient underwent the phenol cauterization for his ingrown nail on the left first toe. In May, he visited our hospital due to delayed healing. In July, his left first toe was amputated resulting from infection and necrosis. Six days later, he was discharged from the hospital after receiving endovascular treatment of the left lower extremity artery, but was readmitted to the hospital in late September due to incompetent healing. The patient underwent valve replacement surgery for aortic stenosis at another hospital and was hospitalized for the third time in late October. He lost consciousness on the day of hospitalization. After the implantation of a pacemaker, a left femoral artery-dorsal foot artery bypass was created. In mid-November, bone sequestrum of the left first toe was removed. During the hospitalization, the patient experienced bleeding from a rectal ulcer, which was treated with a hemostatic method. In mid-December, nine months after the procedure for ingrown nails, he was discharged from the hospital because of healing. Although the treatment of ingrown nails with the phenol procedure has been widely used since it is simple and minimally invasive, this procedure should be performed with caution in cases of suspected ischemia.